Gallbladder Torsion with Accompanying Acute Appendicitis

Gallbladder torsion is a rare clinical entity and it is a difficult condition to diagnose preoperatively. About 500 cases of gallbladder torsion have been reported since 1898, when Wendel first described gallbladder volvulus. This condition most commonly occurs in elderly women and the symptoms of this disease are largely non-specific and they mimic those of acute cholecystitis. Even with the recent advances of radiologic imaging modalities, making a preoperative diagnosis of gallbladder torsion is difficult and most cases are diagnosed at the time of surgery. An early diagnosis and prompt cholecystectomy for this disease are important in order to avoid the complications of gangrene and perforation, and to reduce mortality. A high index of suspicion of gallbladder torsion on the basis of the clinical situation and the specific findings on the radiologic images, usually ultrasonography and computed tomography (CT) scanning, can make the correct preoperative diagnosis possible. Gallbladder torsion is a rare disease, and gallbladder torsion with accompanying acute appendicitis is extremely rare. We report here on a case of gallbladder torsion with accompanying acute appendicitis in an 89-year-old woman and we review the clinical aspects of gallbladder torsion. Unfortunately, the diagnosis of gallbladder torsion was missed in this case, so we retrospectively reviewed and correlated the CT findings with the surgical findings. (J Korean Surg Soc 2009;77:143-148)